CALL TO ACTION

FAMILY ENGAGEMENT IN THERAPEUTIC GROUP HOMESThe Family First Prevention Services Act (PL 115-123) requires therapeutic group homes serving children in the child welfare system to better engage families during placement and for six months after placement. Connection with family is crucial for all children, whether building a foundation for successful reunification or other permanent placement. Studies of children show that consistent and frequent family visitation:

• Lessens trauma and separation anxiety for children. • Improves children’s well-being and adjustment while in care.• Results in faster reunification and shorter stays in out-of-home care.• Lessens developmental impacts on young children.

Providers are responsible for mitigating the social and physical distancing experienced by children during their time in group homes. Setting up communication channels demonstrates respect for the kids, their family, and their culture. Group homes that work in partnership with families — encouraging them to express their needs, and allowing them to be the experts on their own lives — show consistently better outcomes for children.

Therapeutic group homes face many barriers to family engagement. Many providers say that family engagement is not possible, not with the families they see. That is understandable — but unacceptable. Families may not have the capacity to be full partners. Addiction, mental health challenges, and lack of skills and knowledge can create real barriers. Group home systems and cultures also create barriers. Prioritizing family engagement may require a major shift. Safety, comfort, transportation, scheduling, funding, and other challenges must be eliminated as barriers. Organizations must develop and maintain relationships with families in order to act with cultural humility and to provide trauma-informed care.

Every therapeutic group home can improve family engagement. Currently, few children leave group care and return to their families. We can and we must do better. Take the challenge of this call to action. Take at least a few simple steps to improve family engagement for the children you serve.

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BEFORE THE CHILD WALKS IN THE DOORBe ready to welcome the family. Create a collective vision of what welcoming a family looks like. All direct care staff, clinicians, home managers and leadership need to share the commitment to fully consider the family’s unique feelings, culture, and needs.

Organizational Readiness• Conduct a family engagement readiness

assessment for your organization. These assessments help agencies review their own capacity and introduce ways to incorporate culture, language, and family norms into your work. Family Voices and the Building Bridges Initiative offer robust self-assessment tools.

• Develop organizational culture that expresses hope for reunification and permanency. There are many ways to be a successful family. Organizations must believe and communicate this to families.

• Language matters! Stop using deficit-based, parent-blaming language. Never use it — not in front of kids, not with families, and not with the staff. Replace negative words with trauma-sensitive statements. It is possible to be both honest and respectful.

• Develop a family mentor program. Other parents are the only people that truly understand the journey. Develop family liaisons who provide parent-to-parent contact. Also work to engage families as true organizational team members. Current and former parents can be valuable advocates, staff trainers, parent liaisons, quality management reviewers, committee or board members.

• Make parents the center of the child’s treatment team. The treatment team (or child permanency team) exists to support families, not the program. Families should be at every team meeting, along with people they and the child have asked to participate, including cultural or spiritual mentors and leaders. Help families brainstorm who to invite to the team; this may be the first time they have been offered a leadership role.

• Work with the treatment team, schools, health care offices, and community organizations to make families their first point of contact for communications.

• Create policies that emphasize and support the importance of family members (not staff) taking kids to appointments, meetings, and activities. Treat transportation problems as a hurdle, not a barrier.

• Provide staff and residents with access to the kinds of technology that can make communication with family easy, including Zoom, Skype, Facetime, email, and texting. And don’t forget snail mail! Old-fashioned letters offer a low-barrier method for kids to communicate with loved ones.

• Open up your definition of family. All of the child’s trusted adults and support systems should be treated as the family. No child is alone in the world. Case managers or home managers should be working diligently to find supportive adults for all children.

Groundwork for Creating Better Relationships with Families • Make the house look and feel as much like

a home as possible.

• Acknowledge the impact of treatment on the entire family. Train and guide staff to treat each family respectfully, as a unique group with its own set of strengths and challenges. Remember that interventions that are difficult to implement in the family’s real-world setting should not be used in the residential setting.

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WHEN THE CHILD OR FAMILY ARRIVES Family engagement begins with the first interactions.

• Identify a staff member and a child peer to help the child move in and feel comfortable.

• Always encourage the family to join the child at admission. If this is not possible, and if the child has other close family members or other adult supports, invite them to accompany the child. When no one can accompany the child, identify a staff member to help the child unpack.

• Welcome the family or other adults who come with the child. Give a tour of the home, and describe rules, responsibilities, and day-to-day life. Take time to discuss any clothing or material needs.

• Talk specifically about the expectations of both the family and the group home.

o Ask the family about their expectations, needs and vision of reunification. What are their hopes? What for them will make this a successful placement?

o Be clear and honest about the group home’s expectations for families and children, and the reasons behind them.

• Let the family guide the conversation. Ask them to identify goals and tell the team about family

Getting ReadyWashington state developed Parents for Parents, a program that connects parents new to the child protection system with parents who have been through the system and are trained to work as allies. Program outcomes include higher rates of reunification, lower rates of reentry into the child protective system, and increased participation in services and court hearings.

Family Voices, a national organization of families, is committed to keeping families at the center of children’s health care. Resources are available for support, parent advocacy, mentorship, and engagement.

Child welfare policy in North Carolina requires that meetings and discussions about the child do not occur unless the child and family are present. North Carolina facilities are also required to provide transportation for families and allow family access to their children every day of the week.

The Parent Advocacy Program in Jefferson County, Kentucky, selects and trains parents who were previously in the child welfare systems to be peer advocates. Families who worked with peer advocates had children in care an average of 10.2 months, compared to 18.2 months for families without peer advocates.

• Use consistent and easily understood language and terms, and develop systems that are as transparent as possible.

• Identify family member peer supports that can be activated as soon as families enter the child welfare system. On the first day, connect families with lived experience with new families to provide mentorship, guidance, and a listening ear. Also bring families and peer mentors together casually, through training or workshops.

• Create policies that openly embrace family participation and involvement in the home at any time.

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routines. Make sure the family understands your philosophy of family partnership, and that they will be included in meetings and decisions.

• Ask the family about logistical details such as transportation and scheduling needs for visits and appointments, important contacts, and previously scheduled events — and put these details into the child’s file. You are establishing your partnership with the family, and you are also getting critical information to help make connections.

• Create a comfort or safety plan with the family to make sure they understand and approve of the way staff will help their child in a time of crisis. The family may have good ideas about what works to keep their child comfortable when emotions run high.

• Connect families with a parent mentor.

• Tell the family you will contact them daily to let them know how their child is doing, and to check in on the family’s well-being.

Daily contact sounds like a lot, but even a quick text or email message is important to build a relationship and maintain contact. The child should be encouraged to be in contact with family members or other trusted adults on a daily basis. Communication technology can make that simple. Some organizations consider it a critical incident when staff miss a daily contact with a family.

In the first conversation with family, staff need to set the expectation that families will remain involved in their children’s lives — and to establish systems to make that happen.

• Take time to identify as much family contact information as possible. Collect cell phone numbers, land line numbers, message numbers, email addresses, physical addresses, and social media accounts. Include contact info for other trusted, safe adults who are be an important part of the child’s and family’s support system.

• Ask the family what kind of contact works best for them, and make every attempt to communicate in that way.

• At the end of the first conversation with family, arrange for their first family time.

Building RelationshipsCanopy Children’s Solutions in Mississippi sees the family as a partner, which they find crucial to instilling hope and facilitating change. Their policy is to let the family help children unpack and move in whenever possible.

The Family Finding model uses family-driven strategies to locate and engage as many relatives and other supportive adults as possible for each child. These adults work with the system and the family to provide permanent emotional and legal permanency for the child.

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Cultivating Quality Family TimeIttleson Community Residence, families are encouraged to join their child for dinner, help with homework, and make a “tuck-in call” to read a bedtime story or just say good night. This allows families to hold onto some of their routines. Program staff call families every day to share something positive about their child and just to check up on family members.

At SCO Family of Services, when staff receive tickets or donations to attend community events, the children can invite friends and family. Families are invited to outings and encouraged to bring extended family, maintaining connections to the people and life outside of care. Staff support is offered and provided as needed.

Mount Prospect Academy in New Hampshire committed to increasing the number and variety of activities and providing transportation for families seven days a week. Transportation extends across New England. Minimizing barriers and getting families together is the priority, despite the obvious increase in costs and staffing challenges.

ONGOING FAMILY TIME The term “family time” is friendlier and less institutional than “family visitation,” and it acknowledges that family continues despite separation. Family time more accurately describes an attitude of engaging families as partners rather than guests. Staff efforts are crucial to create meaningful family time and set families up for success.

• Help families — children and parents — identify interests, hobbies, and activities that they would like to take part in together

• Use family time to link families to the people and organizations that can help them work toward reunification. These organizations will also be important during aftercare, when the child moves back into the family or another permanent placement.

• Invite families to come for meals, join their children in meal preparation, take part in other activities at the home, or join their child on a group outing. Being with family should not only exist in limited and structured periods of time.

• The entire team needs to make the effort to develop activities that work for families, keeping in mind the need to support their cultural practices. Some families will benefit from more structure to their family time.

• End each family time by making a plan for the next family time, including details such as date and time, location, who will be there, and a transportation plan.

Family time shouldn’t always be structured. Families should feel welcome to stop by at any time. Families are not visitors. Even more importantly, family time should NOT be considered a privilege that children need to earn.

IMPORTANT TAKE-AWAY! It is impossible to emphasize enough the importance to children of regular communication with their families and other important people. In particular, point systems, level systems, and other treatment protocols should NEVER be a reason to prevent contact between children and their families.

It is time to dismantle the kinds of systems that isolate children during a period of stress and upheaval.

Getting ReadyAssessment of system reform in California: Casey Family report of reform

Framework for trauma-informed treatment based in therapeutic family relationships: Teaching Family Model

Building Bridges Initiative guide created by the Family Advisory Network: Engage Us, A Guide Written by Families

Building RelationshipsResidential Interventions for Children, Adolescents, and Families: A Best Practice Guide, 2014

Guide for easing foster care placement and establishing a relationship with family: Children’s Trauma Institute Practice Brief

Benefits of peer support programs: Casey Family Research Summary

Expanding the definition of and locating family: Family Finding, Catholic Community Services of Western Washington

Cultivating Quality Family TimeFamily time visitation reduces trauma to children, lessens time in out-of-home care, and results in quicker reunification when appropriate: Partners for Our Children Family Time Visitation Summary Brief

Thorough review of visitation and family time system: Advocates for Children of New Jersey Research Brief

Family visitation advantages from the courts’ point of view: University of New Mexico Child Protection Services Best Practices Bulletin

RESOURCES

health.umt.edu/ccfwd | ccfwd@umontana.edu

CALL TO ACTIONThe success of therapeutic group homes should ultimately be measured by the number families who are reunited and children who live in permanent, safe, and healthy homes many years after discharge. Let’s all work with families to be more successful. It’s easy to focus on the many barriers to family engagement, but programs across the country are developing ways to promote family connection. Be creative, be flexible, stretch! Embrace the spirit of family engagement — it will improve outcomes for kids and families.

Get Started!Damar Services adopted Building Bridges Initiative best practices to engage families in residential settings. If a child goes 24 hours without family or community engagement, it is managed as a critical incident. Damar’s success with the engaging family has led them to an unusual guarantee: if youth require re-admission after discharge, there is no charge.

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